Study strategies and advice for USMLE no. 2

Continuing our previous blog on study strategies and advice for USMLE, We would like to continue recommending strategies for you to form your own strategy to tackle all the material for any Step, since having a strategy it’s important to your performance we are giving today some tips that hopefully will help you get a really great score in your tests.

Remember that preparing a step it’s not just about studying material and committing to memory facts and numbers, but also it requires you to have a strategy for preparation, a way to prepare you for the possible questions as well as highly used topics and high yield contents.

-Check the topic list:

Before starting a topic in any given subject check if it is important for the exam, there are many subjects that are not included in the exam or some that may be asked but are not regularly used, those should be the last on your list since studying the most used and high yield contents will be a more efficient use of your time.

If there is a topic you think it’s not really being used like for example (just as an example)  physiology of the auditory system, then by all means use your time and effort in a highly used topic like vitamins for example. All in all do some research about the topic you have doubts and ask in forums about it. Remember that it’s possible to ask for help when you need it.

-Write from memory

After you are done with a particularly difficult topic for you, make a quick review and write it down in your own words from memory, there is a part of our memory that helps retention when you write down those ideas. Also it will help you find those gaps that you have forgotten or where you are not sure about some fact.

Your own words will be the best way to review a subject quickly and more comprehensibly than reading cards or facts from other source.

-Check the unusual facts

There are always really unusual facts that are frequently used in the exams, like a protein named avidin that depletes a B vitamin to name one unusual fact, remember to write them down in one side of your review material, there are some that are frequently used in the exams, those particular or awkward signs and symptoms that make a disease different like blue colored sclera in osteogenesis imperfecta type 2, particularly also the clinical findings and manifestations of trisomy diseases and how you differentiate them from each other.

If you find unusual or strange data try to remember it and associate it to a disease, there may be clinical vignettes where you have to recognize the pathology using these unusual findings, including the use of images.

-Get your facts right

If you come across a fact or number that doesn’t seem right or you have doubts about its real value, double check it with a reliable source, search them in a well-known textbook or search online in official websites, it’s important to double check when in doubt since you will have one chance to get it right in the exam.

Also when you have doubts while answering question banks or simply trying to remember a topic, check again if you are not sure of some specific details, don’t leave your doubts in the air, you have to be more of a perfectionist in the case of doubts or missing pieces of information, remember that questions are made to be confusing or make you doubt your own answers so mastering each topic is really important.

-Add your own information

Whenever possible add information from your own research, you may find important details in textbooks or other sources that improve the ones you are working for your exam, add them as a side note, remember that there may be more and better ways to explain a topic that what you are currently reading, also simplicity in words and concepts are easier to remember, explain to others and use in a given situation.

-Associate images with important facts

There is always a really important fact lying in front of you in each image, it’s not just about the recognition of a given image or relation with a diagnosis, but also important details like specific growth media, bacterial growth requirements, specific deficiencies like the case of hemophilia, commonly found anatomical regions for growing a specific type of cancer etc. 

The whole idea is to add more contents to your knowledge when identifying a specific image. So they become available once you see the image presented, this will be important for questions on pathology, histology and medical imaging (x ray, cat scans etc.)

sacroidiosis with psamoma bodies

Keep in mind these tips during your preparation to improve your retention of material, don’t forget to check our tutoring guides at www.usmleprepguide.com to have a detailed tutor for your preparation, also if you have other ideas to help for studying let us know in the comment section.

How to choose your specialty

One of the most important decisions in your practice is the specialty you want to dedicate yourself,since this decision will define your daily life in most cases for the rest of your medical practicing years, it’s a decision that should be taken seriously and also requires you to look for as much information as possible before applying to a residency program.

There is always time:

First it’s important to take your time before deciding, there is no reason to rush your decision based on a good impression or a good mentor being great in their fields, every one of us is different and you should take your time to investigate in to all the different specialties before selecting one.

There is always time to investigate, sometimes it doesn’t take that much to know what you like, many doctors as much as 50% know from very early on what specialty they like, although this might be true many of those are trying to be like a mentor.

Remember that there is also a chance to change your specialty during your first year of residency, so it’s okay to take a chance in a specialty you decide, there is enough time to make a change.

Compare to your experience:

During your clinical rotations you will have a firsthand experience with different specialties including their daily activities, routine work, common cases, physical demands etc. your experience is one of your best tools to compare and decide, although you should look at work and not the glamorous life of some attendants, it’s important to take in consideration more of the work being done than the lifestyle some staff can have, this second part matters but it should be secondary to your decisions.

Pay attention to which rotations you found very passionate about, also discard the one you hated for reasons of work and not people, not all places are alike so if people where the problem do not discard that specialty yet, maybe it needs more consideration.

Your personality counts:

It’s important to know how you take different situations, for example the way you respond to high stressing situations, your attitude towards repetitive paperwork, contact with patients etc., be honest about your limitations and your strengths many people like to be focused for hours others get desperate when standing still for more than 15 mins., try to make the best guess of the person you are in practice, what you like and what you really don’t like so your selection has more foundation in your own personality.

There is always affinity to one type of specialists and you may have a clue of this affinity by the way you handle your relation with residents, they after all represent the personality traits of each specialty, if you find yourself getting along great with a type of residency program students maybe you could be great doing what they do.

It’s what you do:

In the end of all your studies this is the most important thing to take in consideration, it being what you will be doing for the rest of your practice, remember that not all work is done in hospitals and private practices differ from institutional work, so it’s important to consider the way of life of a graduate in your selected specialty as well as the kind of work that they do in a daily basis.

Here are some important questions you should look for a selected specialty at the end of your training:

-Patients: do they take a patient and get to know them well, or is it a high volume a day type of practice.

-Schedule: how many hours a day do they work, do they have time for family and children, travel etc.

-Free time: are they always on call, do they have time to take vacations, are their weekend free etc.

-Stress levels: is it a consultations type of work or is the work more of stressful situations.

-Team work: is it a solo operation or do they work in teams.

-Data: is it required to do research, manage data and analysis.

-Solutions: is the work about finding new solutions and problem solving or is it more a routine structured type of practice.

-Teaching: does it require teaching or talking to audiences or is it more a person to person type of work.

-Income: how much do they make a year?

Take your own research

When deciding your specialty take some time to make a little research for your decisions, there are a lot of resources online to get more information about the salaries, work hours, specialties by personality etc. for every specialty there is, but don’t just take it from the web, make some real research and try contacting real physicians that work in your selected field, ask them all that you can and all they can let you sometimes is better to ask by emails, but a call should be quicker. Don’t take for granted what you red try to contact as many as you think you need to take a decision after all this is a very important decision for your own good.

Most practicing specialist will be glad to find a student interested in their field of work, and most will happily give you some time to answer your questions, just be sure to have them written and ready before you call.

Finally your decision should be made by your own investigation and the things you like and dislike, try not to take in consideration the life of other people since they have their own practice and everyone is different, as always thanks for listening to our ideas, don’t forget to leave your comments below, and visit us at www.usmleprepguide.com and take a look at our USMLE tutoring guides.

USMLE QUESTION BANKS

Question banks are surely one of the most helpful and used methods to prepare for USMLE examinations, it is a great way to test yourself while preparing as well as finding out those subjects you missed or for those where you are having a hard time remembering, using a question bank is surely a great way to increase your understanding and retention of all that material that needs to be covered.

The following tips are meant to improve the results you will get from using question banks:

Get used to the format:

It’s important to get used to the format in which questions are made, using question banks will help you understand how the software works, and this will give you at least 10 mins. More during the real exam since you can skip the tutorial, also is important to learn to use the lab data tab to be able to find quickly reference values.

End of session questions:

The best way to review and increase your retention of a given topic is making questions at the end of the day, at least one hour a day you should take questions of the material revised that day, and this practice will increase your understanding and retention of the material for that day. Taking questions at the end of the day will make your last review of all the material faster and more thorough.

Questions all the way:

There is no reason to wait for the last month to start using question banks, in fact you should start as early as possible, in many question banks you can select the topic you want to review making it easier to test the areas you have reviewed during the day. You should start doing question in the first month of your preparation, this practice will help to increase both your knowledge as well as the way some material will be used in questions, it is important to remember that the way topics are used in a question needs practice as well. 

Take 46 question blocks:

Most question banks can be set to emulate real blocks of 46 questions, this setting will help you in getting used to answer each question within a minute of time and leave the rest of the time to review the questions you leave in blank, also it will help you asses the time you are taking for the whole block. If you practice this way the exam will feel easier and you will have more resilience to long periods of questions.

Read the answers carefully:

Most question banks have their answers with detailed explanations including images, cycles, etc. Explanations are an important part of using question banks, it’s not just about doing a lot of questions, it is better to do less questions and read their answers because this is the way you learn new information, explanations are as important as having the questions wrong, read carefully each answer and their explanation, don’t assume you knew it and skip their answer, sometimes many new information lies in their explanations some may be helpful for the real exam.

Take your own notes:

Once you know what an answer was about, it’s important to do your own notes, also remember to write it down in your own words, explaining something increases your understanding and your retention of that subject, so explaining it to yourself is a really great way to remember important details as well as cycles and mechanisms.

 Follow a study guide:

Using a study guide can help you in organizing your study and keeping track of the questions you have to take for a given week, also it can help to focus on important subjects and high yield contents.

Test your weaknesses:

A great way to increase your retention of confusing or hard to remember material is to test yourself against question banks, it doesn’t matter that you have them all wrong, the fact that you tried will make pay more attention to the answers and will increase your retention of that subject, and also many explanations are detailed and easy to understand.

Your final month:

During your last month before your exam, try to take as many 8 hour question sessions as possible including all subjects, and making it as real as possible to get used to the long hours sessions, during this month you should review your notes as well as answers you are getting wrong.

Hopefully these ideas will help you improve your use of question banks to start tackling all those facts and improve your knowledge, remember that the sooner you start the better your odds will be, as always check our tutoring guides at www.usmleprepguide.com  for detailed guides on every step, Our tutoring guides will provide you with guidance during your preparation, helping you keep track of important topics, it has a design from the most important to least asked topics and also includes tips and hints of how some topics may be asked and when you should memorize formulas, diagrams and images.

if you have other experiences and ideas, please share them with us in the comments,

Step 2 CS hints...part 1

There are lots of anxious candidates when it comes to step 2 clinical skills exam, but in reality it is the easiest of the series it only takes some preparation both in practice as well as knowing what the exam is about,  if you’re planning on taking the exam soon, these tips will help you on your preparation,

Practice a lot:  and we mean a lot, find a partner to practice, its better if its another candidate because both can review  mistakes and improve on your techniques but it could be anyone the important part is to have someone real to practice your physical, your most important aim should be to memorize the contents of each physical exam including neurological, and being able to do the exam without thinking what comes next, you have to practice until it feels easy to make a full body physical and also until you can make it in less than 5 mins. 

The only way to feel you are doing something automatically is to practice a lot; this should be one of your main focus during your preparation.

It’s about the technique not results:  this is important, many of the actors don’t have real findings in many parts of the exam, some can simulate findings like cardiac murmurs, but the reality is that most simulated patients will not have real pathologies, that means that the most important part of the process will be your physical and the correct application of each technique, for example fundoscopy.

Remember that this exam is videotaped for further analysis of your performance and this includes the correct application of each examination technique.

There is no diagnosis:  This is one of those things you should have in mind during all your patient encounters, all the simulated patients have syndromic diagnosis, that means symptoms that are common for many different pathologies and not a specific diagnosis, this is important since every encounter could be many different pathologies and your job is to explore this syndromes looking for the most common diagnosis, this means you should keep your interrogation and physical open to any possibility related to that syndrome, as an example an acute abdominal pain can be many different pathologies like acute appendicitis, pancreatitis, endometriosis, familiar intestinal polyposis etc. it all depends on the gender and age of your patient in relation to the symptoms presented.

If you keep in mind that all patient encounters have syndromes and not specific diagnosis, both interrogation and physical comes down to your imagination and your ability to explore different possibilities. You should prepare for the most common syndromic differentials to make your exploration easier.

Doorway information:  all rooms will have a general view of each patient that includes patients name, age, vital signs and chief complaint. It’s important to asses quickly if there are irregular vitals, remember the patients name and use it, and the most important thing is that the chief complain will give you a hint about the symptoms the patient could have, this is also important to elaborate toward differentials related to that syndrome. 

Once you have a syndrome in mind questions and physical will be directed toward each different diagnosis, this will make every case easier.

Ask a lot:  This sounds easy but it can be a little difficult, since many syndromes could make you focus on a specific diagnosis it becomes hard to think in other types of symptoms to ask, this is why it’s important not to think that each patient has a specific diagnosis, if you have 3 or more differentials in mind you can ask more questions related to  different diagnosis, interviewing skills depend on how much you explore a patient and a big part of this is how many different questions you can make.

A great advice would be to focus on each differential one at a time to be able to explore every possibility.

Hopefully these ideas will help you while preparing for your exam,  we will continue next week with part 2 of our step 2 CS hints, if you have other experiences and ideas, please share them with us in the comments,

Our USMLE STEP 2 CS TUTORING GUIDE, will help you prepare for your examination, it includes tips and information to help you in your preparation. For more information visit us at www.usmleprepguide.com